The Sancta Maria Nursing Facility in the Cambridge Highlands is the site of a is dealing with a “complex cluster” of Covid-19 infections. (Image: Google)

A Cambridge nursing home is dealing with a “complex cluster” of Covid-19 infections that includes one employee, five current residents and two other residents who tested positive after leaving the facility, the city’s public health department said Wednesday. Though the city didn’t name the nursing home, Sancta Maria Nursing Facility is the only one that has reported cases this month, both in a state filing and in recorded messages on its telephone line.

The scope of the problem has grown over the week since the city reported the first three infections Oct. 7. At that point the health department said the three residents had recently been discharged from “area hospitals” and suggested residents had been infected in one or more of the hospitals where they had been treated before being sent to the nursing home. That was because anyone admitted or returning to a nursing home from an overnight stay at a hospital must stay in quarantine for 14 days, and the three infected residents had tested positive while they were in quarantine.

Now the department believes “it is likely that both hospital-acquired infection and transmission among residents in the isolation unit contributed to the outbreak,” the department announcement Wednesday said. Transmission is not supposed to occur in an isolation unit.

The department said the nursing home “is working closely” with the city and state “to prevent additional infections.” But in a weekly report posted Wednesday by the state Department of Public Health, Sancta Maria was listed as not in compliance with state requirements for employee testing because it had tested only 75 percent of its workers in the week from Oct. 1 to Oct. 8. The report also said the nursing home had a D-level deficiency in its latest infection control inspection, which it defined as a lower-level fault. No details were available.

A state unit that investigates infections acquired in a hospital is looking at the hospitals involved, which have not been named, the city said. Omar Cabrera, a spokesman for the state Department of Public Health, didn’t immediately respond to questions.

The five residents still at the nursing home “are symptom-free and recovering,” the local health department said. It said it doesn’t know the condition of the two residents who tested positive after leaving Sancta Maria because they don’t live in Cambridge. The department didn’t report the condition of the employee, who also lives outside Cambridge.

Infections among nonresidents

Wednesday’s announcement was unusual because the department reported information about infections among nonresidents. The local agency does not include people who don’t live in Cambridge in its extensive daily report on Covid-19. That omission can limit information on the spread of the virus here.

The department said no residents in the “general population” at Sancta Maria have tested positive. State rules require the nursing home to test residents and staff once a week until there have been no new infections for two weeks. The most recent positive test was on Oct. 7, the department said.

Before the first new cases around Oct. 2, the city had not reported additional infections among long-term care residents or employees since June 6. Cambridge sponsored a groundbreaking surveillance testing program for all three nursing homes and four assisted living facilities in March and April. The first round of tests of all residents and staff uncovered more than 200 cases, many with no symptoms. The health department had known of only 28.

Round of tests in April 

There has been no more surveillance testing since the city completed the last of three rounds of tests in April. In July, Chief Public Health Officer Claude Jacob told the city’s Expert Advisory Panel that the city was considering returning to long-term care facilities to do more surveillance testing, according to notes of the panel meetings. There was no indication of any plan.

The state requires nursing homes to test 30 percent of workers at least once every two weeks, but residents don’t have to be tested unless there is a new case.

Assisted living centers and nursing homes are supposed to report new cases and deaths among residents and employees daily; those reports are posted on the state Department of Public Health web site. Sancta Maria reported “one to four” newly positive residents on Oct. 6. It has not reported any other new cases among workers or residents since the beginning of October.